Evaluation of patient-perceived health status using the Medical Outcomes Survey Short-Form 36 in an intensive care unit population
Evaluation of patient-perceived health status using the Medical Outcomes Survey Short-Form 36 in an intensive care unit population
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DOI：
10.1097/00003246-199908000-00011
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发表时间：
1999-08-01
影响因子：
8.8
通讯作者：
Long-Krug, S
中科院分区：
文献类型：
--
作者：
Welsh, GH;Thompson, K;Long-Krug, S
目的：由提供者评估的患者基线功能状态与重症监护病房（ICU）入院后的死亡率相关。我们想看看患者在进入ICU前对健康状况的自我感知是否与功能结局相关。设计：对方便样本进行前瞻性调查。环境：单一城市大学附属退伍军人事务医疗中心。患者：199例外科和内科/冠状动脉重症监护室患者，干预措施：无。测量方法：采用医疗结果调查简表36 （SF-36）监测患者评估的基线健康状况，该表格由36个问题组成，评估8个健康状态概念。此外，确定基线功能状态（Zubrod量表），并收集疾病严重程度（急性生理和慢性健康评估[APACHE] II）数据。入院后6周和6个月分别测定患者的Zubrod功能状态（包括死亡率），并计算相关系数。主要结果：我们发现在这种情况下，在9%的样本中收集SF-36健康状态数据是可行的。不到1%的回复是由代理人完成的。SF-36的数据内部一致，包括一般健康感知和身体功能在内的几个量表与患者的Zubrod功能状态相关(r(2) = 0.08, p < 0.001；R (2) = .14, p < .001)，活力（R (2) = .04, p < .01），社会功能（R (2) = .03, p < .05）和身体角色功能（R (2) = .02, p = .053），尽管程度较小。6个月的功能状态也发现了类似的相关性。结论：我们得出的结论是，在ICU环境中使用SF-36具有时间效率，并与6周和6个月的功能预后相关。它也与功能结果相关，如基线Zubrod功能状态或APACHE II疾病严重程度测量。五个问题的一般健康评估部分与结果的相关性几乎与更广泛的36个问题的问卷一样好。使用SF-36可以确定医院间比较的患者群体。它也可能针对需要额外住院后护理的个人，包括康复服务或养老院安置。
Objective: Baseline patient functional status as assessed by providers is correlated with mortality after intensive care unit (ICU) admission. We wanted to see if patient self-perception of health status before admission to an ICU correlated with functional outcome,Design: Prospective survey on a convenience sample.Setting: Single urban university-affiliated Veterans Affairs Medial Center.Patients: One hundred ninety-nine patients in surgical and medical/coronary ICUs,Interventions: None.Measurements: Patient-assessed baseline health status was monitored with the Medical Outcome Survey Short-Form 36 (SF-36), consisting of 36 questions that evaluate eight health status concepts. In addition, baseline functional status (Zubrod scale) was determined and severity of illness (Acute Physiology and Chronic Health Evaluation [APACHE] II) data were collected. Zubrod functional status, which includes mortality, was determined 6 wks and 6 months after ICU admission, and correlation coefficients were calculated.Main Results: We found it feasible to collect SF-36 health status data on a 9% sample in this setting. Less than 1% of responses were completed by proxy. The SF-36 data were internally consistent, and several of its scales including general health perception and physical functioning correlated with patient Zubrod functional status (r(2) = .08, p < .001; r(2) = .14, p < .001) at 6 wks as did vitality (r(2) = .04, p < .01), social function (r(2) = .03, p < .05), and physical role function (r(2) = .02, p = .053), although to a lesser extent. Similar correlations were also found with 6-month functional status.Conclusions: We conclude that use of the SF-36 is time efficient in an ICU setting and correlates with 6-wk and 6-month functional outcome. It correlates as well with functional outcome as either the baseline Zubrod functional status or the APACHE II severity of illness measurement. The five-question general health evaluation portion correlated almost as well with outcome as the more extensive 36-item questionnaire. Use of the SF-36 may define patient populations for comparison across hospitals. It may also target individuals with needs for additional posthospitalization care, including rehabilitation services or nursing home placement.